A commentary on the Rationale of the Diet-Heart Statement of the American Heart Association

The objective of the Rationale of the Diet-Heart Statement of the American Heart Association was to restate the diet-heart recommendations of the American Heart Association and to quote the original publications on which they are based. Examination of those publications reveals that for the most part, they are obsolete or misquoted. The last section of the Rationale concerns the role of genetics and very briefly reviews the epidemiological and dietary intervention trial evidence. The latter discussion may be summarized as meaning that risk levels are in the 90 percentile group of plasma cholesterol levels and that those levels are due to genetic factors which "dietary changes alone cannot normalize." It admits that "all" dietary intervention trials "were flawed in one or another aspect of experimental design." Hope is expressed that the Multiple Risk Factor Intervention Trial and the Lipid Research Clinics Primary Prevention Trial will support the diet-heart theory. The former did not and the latter was designed to test cholestyramine and not diet.